Estimation of Perfusion Index as an Objective Tool for Assessment of Analgesia During Laparoscopic Surgeries Under General Anesthesia:  A Prospective Observational Study.

Mubasher Ahmad  Bhat; Nidhi  Breya; Rajjat  Sharma

doi:10.51168/sjhrafrica.v7i2.2639

Authors

Mubasher Ahmad Bhat Associate Professor, Department of Anesthesia, GMC Srinagar, India.
Nidhi Breya Senior Resident, Department of Anesthesia, AIIMS JAMMU, India.
Rajjat Sharma Senior Resident, Department of Anesthesia, AIIMS Vijaypur, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2639

Keywords:

Perfusion Index, General Anesthesia, Laparoscopic Surgery, Heart Rate, Mean Arterial Pressure, Analgesic Monitoring

Abstract

Background:

Painful surgical stimuli during general anesthesia trigger sympathetic responses that alter heart rate (HR), mean arterial pressure (MAP), and peripheral perfusion. The Perfusion Index (PI), derived from pulse oximetry, may serve as an objective indicator of nociception and analgesic adequacy during surgery.

Aim:

To evaluate the utility of PI as an objective tool for monitoring intraoperative analgesia during laparoscopic surgeries under general anesthesia.

Methods:

This prospective observational study included 40 ASA Physical Status I patients aged 20–50 years undergoing elective laparoscopic surgery under general anesthesia at a tertiary care teaching hospital. PI, Pleth Variability Index (PVi), HR, and MAP were recorded at predefined intraoperative time points, including laparoscopic port insertion. An additional fentanyl bolus (0.5 µg/kg) was administered after the first port insertion. Data were analyzed using paired t-tests and Pearson correlation analysis.

Results:

The mean age of participants was 42.5 ± 8.4 years, with females accounting for 60% of the study population. Mean PI increased significantly from 4.74 ± 1.67 at baseline to 13.61 ± 3.17 following fentanyl administration (p < 0.001). Concurrently, HR and MAP decreased significantly. PI demonstrated an inverse correlation with HR and MAP, indicating reduced sympathetic activity and improved analgesic adequacy.

Conclusion:

PI is a reliable, objective, and non-invasive indicator of intraoperative analgesic adequacy during laparoscopic surgery under general anesthesia.

Recommendation:

Routine use of PI monitoring alongside conventional hemodynamic parameters may improve analgesic titration during surgery. Larger multicenter studies are recommended to establish standardized PI thresholds for clinical use.

Author Biographies

Mubasher Ahmad Bhat, Associate Professor, Department of Anesthesia, GMC Srinagar, India.

MBBS, MD (Anesthesiology) Associate Professor, Department of Anesthesiology and Critical Care, Government Medical College Srinagar, Jammu and Kashmir, India.

Nidhi Breya, Senior Resident, Department of Anesthesia, AIIMS JAMMU, India.

MBBS, MD Senior Resident, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Jammu, India.

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